Doctoring & Healthcare

All Articles in the Category ‘Doctoring & Healthcare’

Calling The Shots

Tonight, after President Obama speaks, PBS airs a NOVA documentary about vaccine science and safety. Vaccines: Calling The Shots. It’s told through the parent, pediatrician, and community lens. If you’ve ever wondered about vaccines in America, it’s time to tune in. I’ve been in touch with the team producing this documentary. Seriously excited to hear this story unfold tonight.

(update Sept 11: watch Calling The Shots online)

I think this is a big deal. This is an investigation on the science of vaccines.

The less the disease exists, the safer I am.

It’s a balancing act. The risks happen to be minuscule… the benefits are enormous

If inclined, follow a team of parents, pediatricians, and communities tonight on Twitter while it airs:  #vaccinesNOVA

Can’t Stop Time

photo (58)I take solace sometimes knowing I can’t stop time. When I look to the clock and trade panic for solace it’s a way to distance myself from the reality that as time marches on in its infinite human construction, I don’t have to think about moments with the boys lost. Every parent hears over and over again that, “it just goes so fast.” I find that advice never helps. Just makes us feel like time with our beloved little humans is slipping through our fingers and I can’t imagine a parent who feels good about that.

My little boy is no longer allowed to be entirely in my grasp as the doors of that big schoolhouse open forever next week. My 5 year-old starts Kindergarten and it’s pretty clear to me that from here forward there will be many forces facilitating his gradual exploration of the world away from our cozy nest.

The solace I mention is real though and it helps me. At moments I can feel the space and peace that comes in knowing I have literally no control over his aging and what it provides — like giving into the wind I can lean into this space and know what a privilege it is to witness this wild ride. It certainly helps that he clearly loves the speed with which life is hurling at him. I see it in moments where he looks at the Kindergarten class list and in the moments where he sticks his right foot out while standing next to his bike and poses as if he’s ready to take a big stage and I feel his thrill as he looks over to his older brother and realizes he finally belongs at the same school. Growing up really is quite a thing to behold.

Being a part of something bigger is a huge part of being human and school is an essential first (or second) step

And although that solace I just mentioned is real I can’t help but tell you that there is certainly a part of me that suffers in these waning summer days. I feel the excitement yes, I lean into the solace yes, but as a working mom I can’t help wonder, “did I do this all right?” Were the last 5 and 1/2 years exactly what I imagined for his time at home preparing for the onslaught of schooling? Was I present, available, ready, and everything I wanted to be? Well, surely not. It’s clear my iPhone got in the way, as did my job, and my ambition to improve children’s health. Thankfully there are ways he shows me he knows he’s got my attention but I can’t help but trip (and fall) sometimes knowing there are infinite ways to raise a child and I do look at those other paths with curiosity.

Today let me tell you this: I’ll hold onto the solace every single moment I see it and I’ll let it mix up with the suffering. I can gently mute the parts of pain that comes with aging and losing the intimacy found between mother and son during toddlerhood and the preschool years. I’ll find that solace when I feel the thrill from peering over the edge of this great big world ahead of him. One thing I know for certain is I’ll enjoy the first moments of Kindergarten next week, too. This little boy of mine is growing up to be a thoughtful, curious, kind, and happy little man. It’s his excitement for the next giant step that will tug me along into September…

This Makes It Tougher: LuluLemon’s False Claim

lulu lunch bagSometimes it can feel that a career of crafting prevention messages can be snuffed out in a moment. Every once and a while this work in media/messaging can take my breath away, for all the wrong reasons. Today, I realize my work educating parents and children about sunscreen use, UV radiation, aging, and skin cancer risks may pale in comparison to the potential power of a single quote on the side of a shopping bag. I mean, how can I compete with a company that sold $1.6B of merchandise last year and likely distributes tens to hundreds of thousands of reusable bags around North America everyday? Shopping bags have the luxury to walk around for years and tuck into peoples lives in remarkably intimate ways. Even I use these bags (or used to) to carry my lunch on a daily basis. It wasn’t until yesterday that I realized I’d been carrying my lunch around in a bag that goes, in part, against my entire mission. When I read about recent dermatologist outrage for Lululemon bag quotes I literally turned my head to my kitchen counter (see photo) and there sat my lunch bag on my counter just staring at me. Under the tote’s handle was the devious myth, “Sunscreen absorbed into the skin might be worse for you than sunshine. Get the right amount of sunshine.”

Now, that’s not true. In fact there is no “right” amount of sunshine and absorption concerns for sunscreen haven’t proved more dangerous than sunshine. Also, absorption varies with age and body site, here I review information about why to use physical sunscreens (and sun protective clothing) in infants when possible to reduce any risk from ingredient absorption because of their more immature barrier. That being said, I’d always recommend sunscreen over sun exposure for infants and children. The conversation about getting sunshine is centered around getting enough vitamin D. Although minutes (not hours!) in the sun provides vitamin D, we can safely get vitamin D entirely from the food we eat or a daily supplement (all children are recommended to have at least 400 IU Vita D daily). We don’t need to consume sun. In fact all sun exposure comes with UV radiation that contributes to mole production, aging, and skin cancers– even the most deadly kind, malignant melanoma. Sun protection keeps skin looking beautiful (prevents aging) and prevents skin from discoloration and cellular/immune changes that can lead to cancer.  Sun-protective clothing, seeking shade, and sunscreen are our best bets for beautiful, healthy skin. Read full post »

The Power Of A Sugar Cube


There’s no question the challenge of unhealthy weight and rising obesity rates in America present a complex problem for children, their parents, and their doctors. No wonder I cycled through so many emotions while watching the new movie Fed Up. As Fed Up premiers all over the United States today it’s provoking a fiery, national conversation about the threats of obesity on our nation’s children. I loved the power behind the film.

Instead of pointing the finger at children for poor choices or limited activity, filmmakers Katie Couric and Laurie David take a deep dive into the mechanics of how food is being made in America, how food companies have contaminated our culture, and how with a changing food source we’re obligated to return to a menu of primarily fresh foods to heal our children.

This movie is guaranteed to cause you to re-evaluate the number of processed foods you bring into your home.

Fed Up is constructed out of powerful interviews and activist-like thinking as national experts illuminate the fallacy that eating less and exercising more will singularly improve the health of our nation and curb the obesity epidemic. It feels a little like a get-out-the-vote campaign blended with a whole new kind of math. In fact there’s lots of new thinking challenging the simplicity of previously held beliefs about energy gap. With overweight and obesity threatening our longevity and our national bank account, Fed Up assures us that we’ll have to take on one big sugar cube, the food industry, to lean-up our nation. Read full post »

New Autism Numbers, Ways To Advocate

1 in 68 from CDCHeadlines soared yesterday with the CDC report that the number of children with autism diagnoses had increased by 30% in the past 2 years. “Reality is there are many children who are having serious struggles because they can’t communicate well and have a hard time being with people,” Dr Chuck Cowan clearly stated to me this morning. Like a bell on a quiet night, I feel parents need to hear this most: we just want to connect children with the resources they need to thrive at home and at school and throughout their lives. Doesn’t matter what we call it, we want children of all backgrounds, of all resources, and all opportunity to be afforded the chance for a connected, lovely life. As a realist of course, I do know that numbers matter because it changes how we screen, how we advocate for children, how we move funds and resources, and how we ensure children get what we need. Numbers help activate.

The new numbers don’t mean anything is different today than it was 2 years ago really. Instead:

The “new” number published this week finds an estimated 1 out of every 68 children here in the US has an autism diagnosis at age 8. Like before, likelihood for autism is more common if you have a family history of autism and 5 times more common for boys compared to girls. Children who aren’t white don’t get identified as having autism as often and we know from numerous studies non-white children don’t get the resources they need like their caucasian counterparts. That’s not new, either. Also, there may be environmental factors at play although data on determining true environmental causes of autism, versus associations, is still unfolding. Researchers are trying to sort out the role for chemical exposures, e.g. how close you live to highways, and what your children eats in predisposing a child to challenges with communication.

Over the past few months I’d say we’ve been bombarded with unsettling news; we’ve heard that autism likely starts before birth, that children born to older fathers are more likely to get the diagnosis and we’ve even heard that taking Tylenol during pregnancy may increase the odds that our children can’t pay attention. I mean, YIPES! Before you entirely freak out, listen to this: Read full post »

Digitally Savvy Parenthood

As a pediatrician, I encourage families to search online for health advice. Yet how you search and where you click matters. Tips for you and your time with “Dr Google” or “Surgeon Bing.”

The Pew Internet Project’s research finds that over 70% of Internet users in the United States say they have looked online for health information in the last year. Furthermore, most health information seekers (ie freaked out parents searching in the middle of the night) don’t start their health search on their pediatrician’s website. More than ¾ of people in the United States start their health search by typing something into a search engine like Google or Bing. Where you click and what you do next is key.

As a mom, pediatrician, blogger and general online enthusiast, here are a few insights to assist you when looking online for health information for your child or family. We parents are active information seekers on our phones and computer ~ I maintain that this is a GREAT thing! For practicing physicians, there is a tricky balance in believing that the Internet can help save lives. Have You Been In To See Doctor Google? A few ideas to improve trust for us all.

7 Tips For Becoming A Savvy Digital Parent:

Read full post »

We Want Your BPOD

And now for something a little different….We want to animate your child’s BPOD (Best Part of Day). Send us a short recording of your child talking about their BPOD and we’ll bring their experience to life in an animated video (see video above)! We’ll never disclose their name or age, just share their journey and insight through their words.

Email your recording to my Seattle Mama Doc email (seattlemamadoc@seattlechildrens.org) by Feb 26, and we’ll select 5-10 recordings to animate and share the first week of March. As a note, I typically record these audio recordings on my iPhone (in “voice memos”) and it allows me to email or share them easily. See below for more details & the text you’ll need to include when you send your audio files! Read full post »

CVS Stops Selling Tobacco

Doctors are tough critics — as well they should be. Today the news that CVS Caremark pharmacies will no longer sell tobacco brought about quite a bit of rapid online dialogue. Even President Obama chimed-in with praise, a response that some in the business world say is worth billions for CVS. Having a good reputation, particularly when you’re in the business of delivering health care and lending health advice, seems essential. In my mind we should praise and celebrate what today brings – leadership for making it harder to get addicted to tobacco products we know seriously harm health.

But not all doctors may think a move to ban the sale of tobacco in a health care environment is enough. Dr Sunny Chan, a family doctor in Canada, asked the tough question about our health care providers (HCP) working environment:

Meanwhile, Texas pediatrician Dr Bryan Vartabedian wrote a blog post this morning asking CVS to take a bigger step  by banning sales of unhealthy sugar-sweetened beverages (that we know are associated with obesity) and junk food. He wrote,

You can’t make money peddling savory snacks while at once setting the pace for a healthy lifestyle.  And condemning one vice works for the press release, but not as a brand offering health solutions.

When focusing singularly on CVS’ decision to stop selling tobacco products, it’s easy to say the choice is a phenomenal one. Not promoting (or profiting) from the sale of carcinogens is always in the best interest of our communities and our long-term health. I return to what Centers For Disease Control’s Director, Dr Thomas Friedman, recently wrote in JAMA , “Tobacco is, quite simply, in a league of its own in terms of the sheer numbers and varieties of ways it kills and maims people.” Read full post »

Reducing Poverty And Improving Health

Yesterday marked the 50th anniversary of Lyndon B Johnson’s 1964 State of the Union address where he made a proclamation to commit to end poverty in our rich nation. Nationally, there has been a huge and beautiful focus on the anniversary. Despite the political divisions and tense partisan discussions on how to proceed in poverty reduction, I heard many reports on the radio, read newspaper coverage, and saw chatter all day on social channels about where we stand. I was floored by the statistics. I’d not, unfortunately, ever before spent time thinking about Johnson’s proclamation and the line in the sand created by his words.

After his proclamation, the country went to work creating Medicare, Medicaid, Head Start (promoting school readiness through social, nutritional, developmental support for children from birth to age 5), food stamp programs, and Job Corps. Since 1965, Head Start alone has served more than 30 million children and set precedent for contemporary thinking on early education and consortiums today like Thrive by Five. Much of the media coverage yesterday focused on the profound progress we’ve made helping Americans quit or reduce cigarette smoking with the Surgeon General’s first Report on Smoking and Health. Still, nearly 1 in 5 Americans (18%) smoke in a country that has proven cigarettes to be the #1 leading cause of preventable death. Dr Thomas Frieden wrote in JAMA yesterday, “Tobacco is, quite simply, in a league of its own in terms of the sheer numbers and varieties of ways it kills and maims people.” Read full post »

My Adorable Activity Tracker. I’m Streaking!

First Day With My Shine

Self-tracking, life-logging, activity-tracking, “the quantified-self (QS) movement” as the smarty-pants say, or as some have asked, “What’s with the weird watch?” Well, I’m hooked. I don’t go anywhere these days without my device. My activity tracker had me at hello.

Over the summer I started wearing the Shine. I’d been waiting for it–it had a significantly delayed shipping date–which only heightened my desire. I’ve worn it every day (except one) since. The world really is different to me now. Before you start to criticize and marginalize my proclamations, know that I waited nearly 1/2 a year to write about this to ensure it wasn’t just a fad.

How My Activity Tracker Is Changing Me:

First things first: I realized how sedentary some of my days are. Especially when I’m writing or working intensely; knowing this has changed how I think about walking. Secondly, I’m really much happier knowing how much movement I have during a day rather than guessing about it. Even when I’ve hardly moved a few paces, I’m thankful for the insight. I mean, some days we pig out, some days we aren’t as hungry and eat salad, some days we run miles. Other days we work and write and sit far too long. My activity tracker helps me understand the patterns and think about new ways to live differently. The boys always want to know how much we’ve moved. This tracker has power around here. If there’s any New Year’s “resolution” that may be worth committing to–it may simply be to check in on how you’re moving. Find a tool to give you observable data. Behavior change perhaps will follow.

To be clear, it isn’t the device I’m attached to that is changing my life, it’s the new experiences I’ve having because of it. New insight from my Shine changes my mood, the way I map out my day, and has undoubtably made me more self-aware. I’m thankful for my consultant.

Reality is, many of us are tracking our lives and our movement without realizing it. Before you write we trackers off, read on.

Read full post »